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 Alternative
and Complementary Therapies
The
field of complementary and alternative medicine encompasses
a vast number of practices and systems of health care that,
for a variety of cultural, social, economic, or scientific
reasons, have not been adopted by conventional medicine.
Conventional
medicine is sometimes referred to as allopathic medicine.
The term allopathy is derived from the Greek allo,
meaning opposite, and pathos, meaning suffering. In
general, conventional medicine tends to focus on the disease
and employs techniques to oppose it. For example, conventional
medicine manages high blood pressure with medications ("antihypertensives")
that lower blood pressure; it treats bacterial infections
with drugs ("antibiotics") that kill the invading
organisms; and for cancer, it employs chemotherapy, radiation,
and/or surgery to remove a malignant tumor or eradicate cancerous
cells.
A
number of alternative and complementary therapies operate
via this allopathic framework, including many of the biologic
and pharmacologic approaches to treating cancer and other
disorders (see below). Other methods derive from distinctly
different origins and reflect concepts of health and disease
that vary greatly from those of Western medicine. Among such
practices are Traditional Chinese Medicine, Ayurveda, homeopathy,
and naturopathy. Of those practices that have evolved from
other, non-Western cultural traditions, there is often no
correspondence with Western concepts of disease. For example,
the notions of cancer and infectious disease have no parallels
in Traditional Chinese Medicine, although the system can be
used to treat such conditions.
Many
complementary and alternative treatments involve difficult
changes in lifestyle or outlook. Some involve bad-tasting
herbs or even animal-based remedies. Conventional medicine
is probably better than most complementary and alternative
treatments at achieving quick fixes. However, complementary
and alternative medicine is worth exploring as a source of
both new treatments and new perspectives on health and disease,
and for approaches to reinforcing the individual's "life
force", balance, and harmony with the environment.
A
few common complementary and alternative treatment approaches
are described below to illustrate key concepts. This list is
far from exhaustive. The inclusion or exclusion of specific
modalities is not intended to imply a value judgment about the
relative effectiveness or appropriateness of any one approach.
Acupuncture/Acupressure:
Acupuncture, as a therapeutic intervention, originated more
than 4,000 years ago from the medical practices of the Chinese
and other Asian cultures. Traditional Chinese Medicine uses
acupuncture to regulate the flow of Qi, or "vital energy"
(see "Traditional Chinese Medicine," below). The
insertion and manipulation of needles, or the application
of pressure at specific points along the meridians or channels
through which Qi is thought to flow, is believed to correct
any imbalance, excess, deficiency, or lack of fluidity in
the flow of Qi. In the West, some practitioners deliver acupuncture
in the context of a broader Asian health care system; others
offer it as a discrete technique for treating symptoms.
Ayurvedic
Medicine: Ayurveda, first described in Vedic religious
scriptures dating from 1200 B.C., is considered the traditional
medicine of India. Central to Ayurvedic philosophy is the
notion that optimal health consists of physical, mental, and
spiritual harmony. The pathway to harmony depends on the individual's
predominant "dosha," or constitution. Ayurvedic
practitioners interview new patients in great detail about
their personal as well as medical history. The four pillars
of Ayurvedic health maintenance are: (1) cleansing and detoxification,
(2) palliation, (3) rejuvenation, and (4) mental and spiritual
hygiene. Diet is an important concern in Ayurveda, but specific
dietary recommendations depend on the individual's primary
constitution, and vary according to the season. Treatment
may include dietary modification, herbal preparations, massage,
yoga, meditation, and "pranayama", or breathing
exercises.
Biologic and Pharmacologic Therapies: These approaches
are similar to Western medicine in their use of specific treatment
agents that are targeted at eliminating a disease or symptom.
Examples include the use of shark or bovine cartilage, which
advocates say has cancer-fighting properties; "antineoplaston"
therapy, which employs a substance originally found in human
urine, but which is now synthesized chemically, to fight various
forms of cancer; chelation therapy, which involves using a
chemical called EDTA; and oxygen therapy, which uses oxygen
in various forms to counter various infections and other disorders.
Chiropractic: Chiropractic originated in ancient Egypt,
where practitioners adjusted the spines of their patients
to maintain health. Modern chiropractic is based on the principle
that proper spinal column alignment is necessary for optimal
health, and it employs manual manipulation of the spine to
correct subluxations, or spinal misalignments. Because of
the crucial role that the nervous system plays in both involuntary
and voluntary bodily functions, chiropractors treat a wide
variety of conditions with spinal manipulation and believe
that preventive treatments are appropriate for maintaining
health.
Dietary and Nutritional Therapies: Dietary and nutritional
considerations are fundamental to many complementary and alternative
healing approaches. Many non-Western cultural traditions make
little distinction between medicine and food because diet
is fundamental to health. Western medicine, too, has begun
to acknowledge the potential importance of dietary and nutritional
supplements to health.
Alternative
and complementary dietary and nutritional modalities include
macrobiotics, vegetarianism, orthomolecular medicine, and
individualized dietary programs. Macrobiotics, based on Asian
concepts of nutrition, tailors diet to both individual needs
and the season. Vegetarian health diets vary widely: some
exclude all animal products, whereas others include milk and/or
eggs and/or fish. Many nutritional counselors support the
use of supplements to replace nutrients that may be lacking
in the diet. Practitioners of orthomolecular medicine prescribe
"megadoses" of nutritional supplements for the prevention
as well as treatment of particular health conditions. Other
nutritional practitioners develop individualized dietary advice
for clients, basing their recommendations on an analysis of
the individual's unique metabolic characteristics.
Energetic Therapies: The term "energetic therapies"
is used to describe practices, including Reiki, external Qi
Gong, therapeutic touch, and bioenergetics, that involve nonlocal
interactions-that is, interactions in which there is no physical
contact between the practitioner and the patient. Some of
these practices originated in non-Western cultures. Others
were developed in the West but show the influence of non-Western
concepts. All of them involve non-tactile, non-contact interactions
between practitioner and patient, in which the practitioner
uses information garnered from other senses to assess and
treat the patient's condition. Traditional Chinese Medicine,
for example, uses this approach to detect and release Qi.
Homeopathy: Contemporary Western homeopathic medicine,
based on the work of the German physician and chemist Samuel
Hahnemann some 200 years ago, aims to stimulate the individual's
innate healing processes through the administration of minute
(homeopathic) dilutions of specific remedies. Derived from
the Greek homeo, meaning same, and pathos, meaning
suffering, homeopathy essentially treats like with like. The
patient describes his or her symptoms in detail, with equal
emphasis placed on both physical and psychological symptoms.
The practitioner then prescribes very small, nontoxic doses
of a selected substance that, at higher doses, would produce
the same symptoms in a healthy person.
Mind-Body Approaches: Although many of the practices
described above inherently involve mind and body, the term
mind-body is used to describe practices, such as yoga, guided
imagery, relaxation techniques, biofeedback, and hypnosis,
that involve self-responsibility and use the relationship
between mind and body to promote health. Recent advances in
psychoneuroimmunology, the study of the biochemical and molecular
relationships between psychological states to health, have
further validated these approaches to health care.
Naturopathy: Naturopathy is a comprehensive system
of health care that draws on Traditional Chinese Medicine,
Ayurveda, and Native American healing practices. According
to naturopathic philosophy, health is a composite of physical,
emotional, mental, and spiritual well-being. The body is seen
as having an innate ability to heal itself and symptoms are
therefore an expression of the body's attempts to heal itself.
As opposed to symptoms, naturopathic philosophy believes it
is the causes of disease that should be treated, and that
prevention is better than cure. Naturopathic practice may
encompass acupuncture, homeopathy, hydrotherapy, botanical
medicine, dietary and nutritional considerations, and counseling
and lifestyle modifications.
Osteopathy: Osteopathic practice rests on the notion
that the mechanical structure of the body is inherently linked
to its function and is the most important factor in maintaining
health. Diagnostic methods rely on detecting structural abnormalities
of the musculoskeletal system and are followed by manual manipulations
to correct the structural problem.
Traditional Chinese Medicine: The system of Traditional
Chinese Medicine (TCM) originated from Taoism some 4,000 years
ago and, like other traditional systems, goes beyond prevention
and treatment of disease. Health care is viewed as one of
several means to a good life-defined as the individual's harmonious
interaction with the community and with the physical and spiritual
environment.
Central
to this ethos is the notion of Qi, usually translated as "vital
energy" or "life force." Qi encompasses that
which distinguishes life from death, animate from inanimate.
Although considered to be the substantive element in living
systems, Qi permeates all of space. The body is thought to
contain a supply of Qi, unique to each individual, that flows
through circular channels or meridians and is exchanged with
the Qi in one's surroundings. Optimal health results from
an unobstructed flow and appropriate balance of Qi.
A
second essential element of TCM is the concept of yin
and yang. The terms refer to the Taoist concept of
the interrelationship and interdependence of opposites. Although
yin and yang are often used to refer to such opposites as
hot and cold or male and female, the TCM practitioner uses
them to describe the functions of organs and organ systems,
illnesses and conditions, and treatments.
Although
TCM is most commonly used in the West to treat illness, its
essential purpose is to promote health and to prevent health
problems. Methods include diet, exercise (T'ai Chi and internal
Qi Gong), the use of herbs, acupuncture, and massage (Tui
Na).
Western Herbalism: Herbal medicine is the most ancient
form of health care. As complementary and alternative medicine
grows in popularity, botanical products derived from Western
plants are coming back into widespread use. Western herbalism
classifies many herbs according to their opposing activity:
for example, herbs may have anti-inflammatory, antimicrobial,
antispasmodic, or hypotensive effects. Additional terms describe
a supportive action: for example, adaptogenic herbs (those
that increase resilience and resistance); tonics (supportive
of vital energy); and emmenagogues (supporting the female
reproductive system). Herbal preparations may be prescribed
for ingestion as teas, as capsules or tablets, or as extracts
or tinctures. Herbs may also be prepared
as essential oils to be used topically, as are herbal preparations
made into salves, balms, or ointments.
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